- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization ... requests for services requiring clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
- Wellpath (Windham, ME)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring… more
- Central Maine Medical Center (Lewiston, ME)
- …plans, implements, and evaluates the needs of patients for discharge planning and utilization review . This includes those who may have Medicare, Medicaid, HMO, ... who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for...nursing with up to six (6) months of Registered Nurse experience. + Current RN license within the state… more
- First Atlantic Health Care (Portland, ME)
- …become certified within the first year of employment. + Currently a registered nurse /licensed in Maine. + Certification upon hire or obtain it during orientation. ... policies, and procedures of the Nursing Services department. + Review and analyze facility activities and data to aid...and cash and risk management and to improve service utilization . + Prepare activity reports to inform management of… more